WO2009158142A1 - Meningococcal multivalent native outer membrane vesicle vaccine, methods of making and use thereof - Google Patents
Meningococcal multivalent native outer membrane vesicle vaccine, methods of making and use thereof Download PDFInfo
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- A61K39/00—Medicinal preparations containing antigens or antibodies
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- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/51—Medicinal preparations containing antigens or antibodies comprising whole cells, viruses or DNA/RNA
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- A—HUMAN NECESSITIES
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
- A61K2039/55505—Inorganic adjuvants
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- A—HUMAN NECESSITIES
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- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
- A61K2039/55511—Organic adjuvants
- A61K2039/55561—CpG containing adjuvants; Oligonucleotide containing adjuvants
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
- A61K2039/55511—Organic adjuvants
- A61K2039/55572—Lipopolysaccharides; Lipid A; Monophosphoryl lipid A
Definitions
- Neisseria meningitidis is a major cause of meningitis and septicemia world-wide.
- Meningococcal meningitis is an inflammation of the meninges, the membrane lining the brain and the spinal cord.
- meningococcal septicemia and meningococcal meningitis, damage is caused by an uncontrolled localized or systemic host inflammatory response.
- Group B meningococcal disease currently accounts for at least one half of all meningococcal disease in many countries including North and South America, and Europe.
- Neisseria meningitidis is divided into 13 serogroups, of which 9 cause invasive disease (A, B, C (Cl, Cl-), X, Y, W-135, Z, and L).
- 9 cause invasive disease A, B, C (Cl, Cl-), X, Y, W-135, Z, and L.
- Five the serotypes are targeted for development of vaccines due to their ability to cause epidemics, including serotypes A, B, C, Y and W135 which are the target of much vaccine research.
- Vaccines against serogroups A, C, Y and W135 of Neisseria meningitidis that cause nearly all invasive meningococcal disease are available and are routinely used with excellent results.
- a suitable vaccine againt group B strains of Neisseria meningitidis has been more difficult to develop for a variety of reasons.
- the capsular polysaccharide which defines the serogroup is ineffective and potentially unsafe for use in a vaccine because it has the same structure as polysialic acid found on certain human cells, specifically blood cells.
- the present technology provides a vaccine comprising native outer membrane vesicles (NOMVs) obtained from at least two meningococcal strains that have been genetically modified to provide broad based protection.
- the native outer membrane vesicles include three different sets of antigens based on PorA, LOS, and conserved outer membrane proteins; and the genetically modified strains have been modified to provide enhanced safety based on inactivation of ipxLl, synX, and lgtA genes.
- the two meningococcal strains can both express LOS having a different LOS core structure and has an alpha chains consisting of glucose and galactose.
- Each strain may express at least two different PorA subtype proteins or subtype epitopes which are chosen based on the most prevalent of PorA subtypes among group B case isolates.
- the vaccine may further include a different conserved surface protein with demonstrated capacity to induce bactericidal antibodies is over-expressed in each strain and are taken from the group consisting of FHBP (GNA1870) variants 1, FHBP variants 2, and FHBP variants 3; NadA; App; NspA; TbpA and TbpB.
- the present technology provides a combination of NOMVs from three genetically modified, antigenically diverse Neisseria meningitidis strains.
- At least one of the stains is selected from (1) H44/76 HOPS-DL which has the following genetic modifications or characteristics :inactivation of the genes synX, IpxLl, and lgtA; insertion of a second porA gene (subtype Pl.7-1,1) in the place of opaD; increased expression of NadA; and stabilized high expression of Ope and PorA; (2) 8570 HOPS-G A L which has the following genetic modifications or characteristics: inactivation of the genes synX, IpxLl, and lgtA; insertion of a second porA gene in place of opaD; increased expression of factor H binding protein variant 1; and stabilized high expression of PorA and Ope; and/or (3) B16B6 HPS-G 2 A which has the following genetic modifications or characteristics: inactivation of the genes synX
- the present technology provides a vaccine composition against meningococcal disease, more preferably group B meiningococcal disease, including native outer membrane vesicles (NOMVs) from one or more genetically modified strains of Neisseria meningitidis.
- group B meiningococcal disease including native outer membrane vesicles (NOMVs) from one or more genetically modified strains of Neisseria meningitidis.
- NOMVs native outer membrane vesicles
- the one or more genetically modified strains has been modified by: inactivation of the synX gene, inactivation of the ipxLl gene, inactivation of the lgtA gene in each strain resulting in expression of a shortened or truncated lipooligo saccharides (LOS) that lacks lacto-N-neotetraose tetrasaccharide, and/or insertion of at least one second antigenically different porA gene in place of the opa gene.
- the genetically modified strain further comprises increased or stable expression of at least one minor conserved outer membrane protein, and/or stabilized expression of at least one outer membrane protein.
- the at least one second antigenically different porA gene may express at least one PorA subtype protein or subtype epitope selected from the most prevalent of PorA subtypes of meningitidis group B isolates.
- the present technology provides a genetically modified vaccine strain of Neisseria meningitidis subtype B strain.
- the genetically modified vaccine strain may include H44/76 HOPS-D strain (Bl), 8570 HOS-Gl strain (B2), and/or B16B6 HPS-G 2 A strain (B3).
- the present technology provides a genetically modified vaccine strain of Neisseria meningitidis subtype B derived from: H44/76 strain comprising the genetic modifications of i) inactivation of a synX gene, ii) inactivation of the IpxLl gene, iii) inactivation of the lgtA gene, iv) insertion of a second porA gene in the place of a opaD gene, v) increased expression of NadA compared with the native strain, and vi) stabilized increased expression of Ope and PorA proteins.
- the genetically modified strain was derived from the ET-5 wild type strain H44/76 (B:15: P1.7,16: L,3,7:P5.5,C).
- the present technology provides a genetically modified vaccine strain of Neisseria meningitidis subtype B strain: derived from 8570 comprising the genetic modifications of:i) inactivation of a synX gene, ii) inactivation of the IpxLl gene, iii) inactivation of the lgtA gene, iv) insertion of a second porA gene in place of opaD;v) increased expression of factor H binding protein variant 1 ; and vi) stabilized increased expression of PorA and Ope proteins.
- the genetically modified strain was derived from the ET-5 wild type strain 85 70(B:4: P 1.19,15: L3,7v: P5.5,11,C).
- the present technology provides a genetically modified vaccine strain of
- Neisseria meningitidis subtype B derived from B16B6 comprising the genetic modifications of: i) inactivation of a synX gene, ii) inactivation of the ipxLl gene, iii) inactivation of the lgtA gene, iv) insertion of a second porA gene (subtype Pl.22-1,4) in place of opaD;y) increased expression of factor H binding protein variant 2; and vi) stabilized increased expression of PorA and Ope proteins.
- the genetically modified strain is derived from the ET-37 wild type strain B16B6 (B :2a:P 1.5,2: L2:P5.1,2,5).
- the present technology provides a genetically modified strain grown in iron deficient medium.
- the present technology provides a genetically modified strain wherein inactivation of synX gene, IpxLl gene, or lgtA gene is by an insertion of a drug resistance gene within the sequence of the inactivated gene.
- NOMVs derived from the genetically modified strains of the present technology.
- the NOMV are prepared from packed cells or spent culture medium without exposure to a detergent or denaturing solvent.
- the vaccine may further comprise one or more adjuvants.
- the genetically altered strain is altered to express iron uptake proteins.
- the present technology provides a vaccine against meningococcal disease comprising a variety of native outer membrane vesicles (NOMVs), wherein at least some of the NOMVs are essentially free of expression or sialylation of lipooligosaccharide (LOS), contain LOS that includes a lipid A with a penta-acyle structure and contain increased expression levels of at least one minor conserved outer membrane protein, wherein the minor conserved outer membrane protein is selected from proteins that induce bactericidal antibodies.
- the minor conserved outer membrane protein can be selected from the group consisting of Nad A, factor H binding protein (FHBP) variant 1, and FHBP variant 2.
- At least some of the NOMV comprise shortened or truncated LOS that are essentially free of lacto-N-neotetraose (LNnT) tetrasaccharide and/or at least some of the NOMV comprise two or more different PorA proteins.
- LNnT lacto-N-neotetraose
- the present technology provides a method of eliciting an immune response to meningococcal disease in an animal or human comprising administering the composition containing NOMVs from at least one genetically altered strain of N. Meningiitdis to the animal or human for immunization against meningococcal disease. The vaccine is used for immunization against group B meningococcal disease.
- the present technology provides a method of preparing a genetically modified strain of N.
- meningitidis for use in a vaccine against meningococcal disease comprising the steps of: a) selecting a strain of meningococcal type B able to be genetically modified; b) genetically modifying the strain by inactivating the synX gene, c) genetically modifying the strain by inactivating the ipxLl gene, d) genetically modifying the strain by inactivating the lgtA gene, and e) genetically modifying the strain by increasing expression of one or more minor conserved outer membrane proteins.
- the method further comprises genetically modifying the strain by inserting at least one second antigenically different porA gene into the open reading frame of the opa gene.
- the method further comprises the step of genetically modifying the strain to stably express or over express at least one outer membrane protein by replacing the poly-C sequence within the promoter or open reading frame of the at least one outer membrane protein with a sequence containing G and C nucleotides.
- the present technology provides a method of preparing a vaccine against meningococcal disease comprising the steps of: a) culturing a genetically modified strain of ⁇ . meningitidis comprising one or more modification selected from the group consisting of inactivation of the synX gene, inactivation of the IpxLl gene, inactivation of the IgtA gene, insertion of at least one second antigenically different porA gene in place of the opa gene, increased or stable expression of at least one minor conserved outer membrane protein, and/or stabilized expression of at least one outer membrane protein; b) expanding the culture by fermentation using the cultured strain of a) to inoculate medium in a fermentor; c) inactivating the fermented culture; d) harvesting N. meningitidis cultured cells by continuous flow centrifugation and collecting cell paste; e) isolating ⁇ OMVs from the cell paste; and f) resuspending ⁇ OM
- Figure 1 is a flow chart depicting the preparation of a master cell bank of cells for the genetically modified strains of Neisseria for vaccine production.
- Figure 2 is a flow chart depicting the production of the cell bank preparation used for making the genetically modified strains of Neisseria for vaccine production.
- Figure 3 is a flow chart depicting the fermentation of the Neisseria used for making the genetically modified strains of Neisseria for vaccine production.
- Figure 4 is a flow chart depicting the purification of NOMVs from the genetically modified strains of Neisseria for vaccine production.
- Figure 5 is a continuation of the flow chart from Figure 4.
- Figure 6 is a picture of a coomassie blue stained gel showing the protein content of standard marker (lane 1), control 8570 HOPS-G NOMV preparation (lane 2), filtered bulk vaccine (lane 3) and final product vaccine (lane 4).
- Figure 7 is a silver stained gel showing lipooligosaccharide content of the vaccine.
- Lane 1 is the control ML5 LPS
- lane 2 is the filtered bulk vaccine
- lane 3 is the final vaccine product. Fifteen ⁇ l of a 1 :2 dilution of 100 ⁇ g/ml of the vaccine were run on the gel (20 ⁇ l of 100 ⁇ l/ml of 1 :2 dilution of control).
- Figure 8 is a picture of an antibody stained western blot showing the identity and composition of the proteins found in the 8570 HOPS-G NOMV vaccine.
- Figure 9 is a graph depicting the TNF- ⁇ released from human blood after incubation with different concentrations of the vaccine.
- Figure 10 is a graph depicting IL-6 release from human blood following incubation with different concentrations of the genetically modified NOMV vaccine.
- Figure 11 is a graph depicting the TNF- ⁇ released from human blood after incubation with different concentrations of the genetically modified vaccine as compared with DOC-extracted OMV from strain 44/76.
- Figure 12 is a bar graph depicting the bactericidal titers of mice vaccinated with different concentrations of the 8570 HOPS-G Vaccine with or without an adjuvant.
- Figure 13 is a bar graph depicting the bactericidal titer of mice vaccinated with 8570 HOPS-G Vaccine against different test strains.
- Figure 14 is a graph depicting the results of the bactericidal antibody depletion assay for LOS, GNA1870, NOMV and Ope antigens.
- Figure 15 depicts the antibody response of rabbits vaccinated with the 8570 HOPS-G NOMV vaccine with and without adjuvant.
- Figure 16 is a graph depicting the results of an bactericidal depletion assay for test strains against the 8570 HOPS-Gl NOMV vaccine.
- Figure 17 is a graph depicting the results of the bactericidal depletion assay for LOS and FHBP antigens for the the 8570 HOPS-Gl PorA knockout strain.
- Figure 18 is a representation of phenotype of the three genetically modified strains of Neisseria
- Figure 19 is a representation of the plasmids used to construct the genetically modified strains of Neisseria: a) plasmid constructed to knockout igtA, b) plasmid to express second PorA, c) plasmid to overexpress fHbp driven by orthologous (Ptac if E. coli) promoter, and d) plasmid to overexpress NadA driven by a homologous promoter (PorA promoter of N. meningitidis) and the e) representational scheme of transformation of N. meningitis with fHbp (variant 1 and 2) and ⁇ adA overexpression plasmid via homologous recombination replacing NspA gene.
- a) plasmid constructed to knockout igtA b) plasmid to express second PorA
- Figure 20a is depiction of the stabilization of the truncated LOS immunotype of ⁇ OMV vaccine strain by knockout of the IgtA gene of the three genetically modified strains.
- Figure 20b is an picture of an immunoblot of the expression of LOS alpha chain by the genetically altered strain B2 and the parental strain (B16B6) with monoclonal antibodies against L3, 7,9 (left) and L8 (right).
- Figure 21 is a picture representation showing the expression of fHbp variant 2 in the genetically modified strain B3.
- Figure 21a) shows selection of the strain containing the gentamicin resistance recombinant containing the overexpressed fHbp by immunoblotting and
- Figure 21b) is a Western Blot using JAR4 monoclonal antibody to fHbp showing increased expression of fHBp.
- the present technology provides a broadly protective vaccine composition for use in immunization against meningococcal disease, more preferably Neisseria meningitidis subgroup type B.
- a vaccine composition including native outer membrane vesicles (NOMVs) from at least one, preferably at least two, more preferably at least three genetically modified strains of Neisseria meningitidis.
- NOMVs native outer membrane vesicles
- Native outer membrane vesicles also known as blebs, are vesicles formed or derived from fragments of the outer membrane of gram negative bacterium naturally given off during growth and may be obtained from culture medium or from the cells by mild methods that do not use detergents or denaturing solvents.
- NOMV typically comprise outer membrane proteins (OMPs), lipids, phospholipids, periplasmic material and lipopolysaccharide (LPS) including lipooligo saccharides.
- OMPs outer membrane proteins
- lipids especially pathogens like N. meningitidis, often shed ⁇ OMVs during virulent infections in a process known as blebbing.
- ⁇ OMV are vesicles produced from the outer membrane of bacteria without the used of chemical denaturation processes and are produced from the genetically modified strains which are antigenically diverse and have each been genetically modified to improve safety, antigenic stability, and the breadth of the protective immune response.
- One embodiment of the present invention provides a vaccine composition comprising native outer membrane vesicles (NOMVs) derived from at least two or more genetically modified strains of N. meningitidis, preferably at least three different genetically modified strains.
- NOMVs native outer membrane vesicles
- Some embodiments of the present technology provide antigentically diverse strains of N. meningitidis, preferably subtype B which include at least three genetic modifications within the genome of the bacteria, more preferably at least five genetic modifications, more suitable at least six genetic modifications.
- the genetic modifications can include one or more of the following: 1) inactivation of the synX gene, which is essential for sialic acid biosynthesis and results in no capsule expression or sialylation of lipooligo saccharide (LOS); 2) inactivation of the ipxLl gene which results in a significantly less toxic LOS having lipid A with a penta-acyl structure; 3) insertion of a second, antigenically different porA gene in place of one of the opa genes (OpaC or OpaD); 4) increased expression of at least one minor conserved outer membrane protein, the minor conserved outer membrane protein demonstrating the ability to induce bactericidal antibodies (for example, but not limited to, ⁇ adA, factor H binding protein (FHBP) variant 1, and FHBP variant 2); 5) inactivation of the lgtA gene in each strain which results in the expression of a shortened or truncated LOS that lacks the lacto- ⁇ -neotetraose (LNnT)
- the present technology provides genetically modified strains that provide both increased safety of use and increase the breadth of the protective antibody response to meningococcal disease.
- the genetically modified strains provide increased safety by incorporating at least one of the following mutations into the bacterial genome: deletion of the synX gene which blocks sialic acid synthesis of capsid and results in the formation of capsule-negative phenotype NOMVs, deletion of the IpxLl gene which reduces the endotoxin activity by resulting in a penta- acyl lipid A structure, and/or deletion of the lgtA gene which block lacto-N-neotetraose biosynthesis on the lipooligo saccharide (LOS) which stabilized the truncated LOS structure; more preferably the genetically modified strains provide two of these mutations, most preferably the genetically modified strains provide all three of these mutations.
- LOS lipooligo saccharide
- the genetically modified strains have an increased breath of protective antibody response by targeting at least one of three sets of possible protective antigens contained within the NOMVs.
- the three possible antigens targeted include at least one of the following: PorA protein, at least one conserved minor protein, and/or the LOS core structure, and include any combination thereof.
- the genetically modified strain targets at least two of the possible protective antigens, most preferably targeting all three of the possible protective antigens.
- the synX- mutation (inactivation of the synX gene) was inserted into the genetically modified strain by a method as described in U.S. Patent 6,558,677, incorporated by reference herein in its entirety.
- a pUC19-based plasmid containing the synX gene in which 200 bp sequence was replaced by a kanamycin resistance gene is used to transform the genetically modified strain. Kan resistant transformants were selected and tested by PCR for the presence of the disrupted synX gene and for the capsule negative phenotype.
- This synX- mutant was constructed based on results and sequence information reported by Swartley and Stephens (Swartley and Stephens (1994) J. Bacteriol.
- a suitable plasmid for use in transforming meningococci was constructed using the following procedure. Three D ⁇ A sequences were pieced together using the splicing by overlap extension (SOE) polymerase chain reaction (PCR) technique (Horton et al. (1989) Gene 77: 61-65).
- SOE overlap extension
- PCR polymerase chain reaction
- a putative uptake sequence, ACCGTCTGAA was added by including it at the end of the PCR primer used to amplify the synXB 67 to 691 base sequence.
- a kanamycin resistant colony was selected, the D ⁇ A extracted, purified, and cut with Xbal. Another copy of the presumptive uptake sequence was ligated into this multiple cloning region site and the resulting plasmid again used to transform E. coli DH5 ⁇ and kanamycin resistant colonies screened by PCR for presence of the additional uptake sequence.
- Plasmid D ⁇ A was isolated from a selected colony and used as a template for PCR using primers that amplified only the insert part of the plasmid excluding the ampicillin resistance gene which should not be introduced into N. meningitidis. The amplified D ⁇ A was then purified and used to transform the genetically modified ⁇ . meningitidis strain. The synX(-) mutant of ⁇ . meningitides was selected by kanamycin resistance and confirmed by PCR amplification of the modified region.
- the ipxLl gene was inactivated in the genetically modified strains to produce a reduced endotoxic LOS expressed on the ⁇ OMVs in the vaccine compositions.
- the lipid A of N. meningitidis LOS is normally a hexa-acyl structure and is responsible for the endotoxic properties of the LOS.
- Two acyl-oxy-acyl linked secondary fatty acids present in the lipid A are important for endotoxic activity.
- the genetically modified strain includes the ipxLl mutant as described by van der Ley and co-workers (van der Ley, P., Steeghs, L., Hamstra, HJ., van Hove, J., Zomer, B., and van Alphen, L. Modification of lipid A biosynthesis in Neisseria meningitidis ipxL mutants: influence on lipopolysaccharide structure, toxicity, and adjuvant activity.
- IpxLl gene resulted in expression of normal levels of penta-acyl LOS with greatly reduced endotoxicity as tested by both rabbit pyrogen test and by cytokine release assay using human monocytes from whole blood.
- Other methods for disrupting the IpxLl gene are contemplated in further embodiments of the present technology for use in developing the genetically modified strains.
- the genetically modified strain contains an insertion of a second, antigenically different porA gene in place of one of the opa gene (OpaC or OpaD).
- the major outer- membrane protein, Porin A or PorA of Neisseria meningitidis, is the product of the porA gene.
- PorA has wide antigenic variation and is subject to phase variations to evade immune selective pressure; therefore it is not always cross-protective to other subtypes.
- at least one additional porA gene is inserted into the opaC or opaD gene of the genetically altered strain.
- the PorA serotype selected for insertion is selected based on the most prevalent forms of PorA found in cases of subtype B meningococcal disease.
- Suitable PorA serotypes include, but are not limited to: Pl.7-1, (from strain M1080); Pl.22, 14 (from strain M4410); Pl.22, 1,4; or other suitable PorA serotypes as to be understood by one skilled in the art or described in the current literature, for example, as described by Sacchi et al., Diversity and prevalence of PorA types in Neisseria meningitidis serogroup B in the United States, 1992-1998, J Infect Dis. 2000 Oct; 182(4): 1169-76.
- the second PorA genes may be under control of any suitable strong promoter that provided expression of the PorA protein, for example the PorA promoter from suitable strains, e.g., H44/76 strain.
- suitable strains e.g., H44/76 strain.
- Suitable methods of cloning the porA gene into the genetically altered strain would be known to a person skilled in the art, and can include, but is not limited to homologous recombination.
- the porA gene may be PCR amplified from bacterial chromosomal DNA, cloned into a cloning vector and recloned into an appropriately constructed plasmid, for example pUC19, using gene splicing by a modification of the overlap extension PCR technique.
- This construction plasmid can be introduced into the bacterial genome via homologous recombination such as to replace the opa gene.
- Transformants may be selected by colony blotting with monoclonal antibodies to the Porin. These methods are known to one skilled in the art.
- the modified strains have stable and/or increased expression of at least one minor outer membrane protein. Suitable minor outer membrane proteins demonstrate the ability to induce bactericidal antibodies (for example, but not limited to, NadA, factor H binding protein (FHBP) variant 1, and FHBP variant T).
- Suitable conserved minor proteins include, but are not limited to, NadA, FHBP variant 1 and 2, and Ope.
- Methods of stabilizing and/or overexpression of the minor outer membrane protein (OMP) include use of expression plasmids and homologous recombination, or other suitable methods that are known to one skilled in the art.
- the minor OMPs can be under a strong promoter, for example, but not limited to the N. meningitidis PorA promoter or IPTG-inducible E. CoIi ptac promoter.
- construct plasmids were used to establish increased expression of fHbp 1 and fHbp 2 in the genetically modified strains, where the overexpressed protein appeared properly processed, lipidated, and translocated to the surface of the outer membrane.
- expression of v.l under the control of IPTG-inducible E. coli Ptac promoter in strain 8570 HOPS-G (B2) was about 4-fold higher than in the parental strain 8570 and expression of v.2 in strain B16B2 HPS-G 2 A (B3) was 32-64 fold higher than in the parental strain B16B6 (See Figure 20).
- an expression system that utilized the PorA promoter could be used to stabilize/overexpress the minor conserved proteins.
- the genetically modified strains include inactivation of the lgtA gene which results in the expression of a shortened or truncated LOS that lacks the lacto- ⁇ -neotetraose (LNnT) tetrasaccharide.
- phase-variation occurs due to high-frequency mutations in homopolymeric tracts of nucleotide residues in lgtA and other neisserial genes. These mutations switch on or off the expression of the LgtA transferase which mediates the assembly of the LOS ⁇ -chain (altering the configuration of substituents on heptose two). This phase- variable activation of the lgtA gene may lead to undesirable elongation of the LOS ⁇ -chain resulting in lacto N-neotetraose which has structural similarity to human blood cell antigens.
- the genetically modified strains of the present technology have the lgtA gene knocked out by disrupting the native gene with a antibiotic marker or other suitable marker (for use in screening for alternations in the gene), for example, but not limited to the zeomycin resistance gene.
- a antibiotic marker or other suitable marker for use in screening for alternations in the gene
- Methods of knocking out the lgtA gene are known to one skilled in the art including, but not limited to construct plasmids and homologous recombination or transformation.
- the mutated AlgtA gene was inactive in all modified strains during at least 22 observed passages and this was a stabilized truncated form of the LOS core structure.
- the deletion of the lgtA gene stabilizes the truncated ⁇ -core LOS structure, for example, providing the truncated core structures as depicted in Figure 19, wherein three exemplary modified strains are shown, for example the B3 strain contains the L8 alpha chain with the L3 core structure.
- the genetically modified strains of the preset technology contain specific LOS core structures corresponding to immuno types L3, L5 and L2 providing stabilized core structures in which an immune response can be mounted, and in the examples below demonstrate truncated L8-like LOS (L8-3, L8-5, and L8-2) which are able to kill wild type strains expressing full length LOS.
- AlgtA strains are able to elicit antibodies that recognize both the truncated and full-length forms of the LOS structure, without cross-reacting with the lacto-N-neotetraose oligosaccharides found on human blood cells.
- the genetically modified strains of N. meningitidis have stabilized expression of outer membrane proteins that are normally susceptible to phase variation in wildtype strains, for example, but not limited to, Ope and PorA.
- the expression of these proteins can be stabilized by methods known in the art, and include the method of replacing the polymeric repeat sequence in either the promoters or within the reading frame of the gene being stabilized with a non-repeating sequence of optimal length form maximal expression.
- part of the poly-C or poly-G sequence in the promoter of these genes can be replaced with a sequence of the same length containing both C and G nucleotides, for example, 12 bp poly-G sequence of the promoter of opcA (see Seq. ID. No. 1) was replaced with a new sequence of the same length containing both C and G nucleotides and a Not I site (See Seq. ID No. 2, Not I site underlined).
- the poly-G sequence in the PorA promoter (for example, see Seq. ID No. 3) can be replaced with a new sequence containing both C and G nucleotides.
- Further embodiments of the present technology provide growth of the vaccine strains in liquid medium containing a low level of iron in order to induce protein expression of proteins involved in uptake of iron, for example transferring binding protein A and B.
- the medium used did not contain specific addition of iron chelators such as desferol.
- One suitable medium is modified from that published by BW Catlin (Catlin BW. (1973) J. Infec. Dis. 128: 178-194) by replacing sever individual amino acids with 1% casamino acids (certified, Difco Laboratories).
- the medium contained per liter: 0.4 g NH 4 Cl, 0.168 g KCl, 5.85 g NaCl, 1.065 g Na 2 HPO 4 , 0.17 g KH 2 PO 4 , 0.647 g sodium citrate, 6.25 g sodium lactate (60% syrup), 0.037 g CaCl 2 .2H 2 O, 0.0013 g MnSO 4 -H 2 O, 5 g glycerol, 0.02 g cysteine, 10 g casamino acids, 0.616 g MgSO 4 , and distilled water to one liter.
- the same iron deficient medium was used for the starter flasks and the final culture flasks or fermenters.
- the vaccine composition of the present technology which include NOMVs from at least three different genetically modified strains of subgroup B can provide three potential levels of protection or three types of antigens that each potentially induce a protective antibody response.
- the three antigens are the PorA protein (six different PorA subtypes are present in the vaccine, two on each of the three vaccine strains); the lipooligosaccharides (three different LOS core structures are present in the vaccine, one from each strain); and the conserved minor proteins Nad A, FHBP variants 1 and 2, and Ope, which have been over expressed in the vaccine strains.
- PorA has a relatively high level of antigenic variation with several hundred different sequence variations having been identified, certain PorA serosubtypes are much more frequently encountered than others and a modest number of different serosubtypes may potentially protect against more than half of group B disease.
- Having more than one antigen capable of inducing bactericidal antibodies in the vaccine is important because it has been shown that when the surface density of an antigen is low, antibodies to it may not be able to initiate a complement mediated lytic event. But if antibodies to two or more such antigens are present the antibodies can together initiate complement mediated lysis.
- Genetically modified strains of the present invention include, but are not limited to, the three strains depicted in Figure 18, including Bl (44/76 HOPS-D), B2 (8570 HOPS-Gl) and B3 (B16B6 HPS-G2) strains.
- the present technology provides a vaccine that provides broad spectrum protection against meningococcal disease, specifically meningococcal disease caused by Neisseria meningitidis subgroup B.
- the vaccine composition of the present invention can be combined with the existing tetravalent A, C, Y, and W- 135 vaccine to provide protection against a majority of pathogenic serogroups of N. meningitidis.
- the vaccine of the present technology may also provide back up protection against the other pathogenic serogroups as well as the minor serogroups of meningococci since the subcapsular antigens on which it is based are shared across all serogroups of meningococci.
- the genes of interest or DNA of interest is delivered and integrated into the bacterial chromosome by means of homologous and/or site specific recombination.
- Integrative vectors used to deliver such genes and/or operons can be conditionally replicative or suicide plasmids, bacteriophages, transposons, or linear DNA fragments obtained by restriction hydrolysis or PCR amplicification as known by one skilled in the art.
- integration is targeted to chromosomal regions dispensable for growth in vitro.
- the gene of interest or DNA of interest can be delivered to the bacterium by means of episomal vectors such as circular/linear replicative plasmids, cosmids, plasmids, lysogenic bacteriophages,or bacterial artificial chromosomes.
- episomal vectors such as circular/linear replicative plasmids, cosmids, plasmids, lysogenic bacteriophages,or bacterial artificial chromosomes.
- Selection of recombination events can be selected by means of selectable genetic markers such as genes conferring resistance to antibiotics (e.g., kanamycin, zeomycin, erythromycin, chloramphenicol, gentamycin, etc.), genes conferring resistance to heavy metal and/or toxic compounds or genes complementing auxotrophic mutations.
- recombination can be screened by PCR amplification, sequencing, restriction digestion or other methods known to one skilled in the art.
- a "vaccine” as referred herein is defined as a pharmaceutical or therapeutic composition used to inoculate an animal in order to immunize the animal against infection by an organism, preferably a pathogenic organism.
- Vaccines typically comprise one or more antigens derived from one or more organisms which on administration to an animal will stimulate active immunity and protect that animal against infection with these or related pathogenic organisms.
- the purified NOMVs are prepared for administration to mammals, suitably humans, mice, rats or rabbits, by methods known in the art, which can include filtering to sterilize the solution, diluting the solution, adding an adjuvant and stabilizing the solution.
- Vaccines of the present invention may be administered to a human or animal by a number of routes, including but not limited to, for example, parenterally (e.g. intramuscularly, transdermally), intranasally, orally, topically, or other routes know by one skilled in the art.
- parenteral e.g. intramuscularly, transdermally
- intranasally orally, topically, or other routes know by one skilled in the art.
- parenteral includes intravenous, subcutaneous, intradermal, intramuscular, intraarterial injection, or infusion techniques.
- the vaccine may be in the form of a single dose preparation or in multi-dose flasks which can be used for mass vaccination programs.
- a vaccine composition of the present technology is typically administered parenterally in dosage unit formulations containing standard, well-known nontoxic physiologically acceptable carriers, adjuvants, and/or vehicles.
- the vaccine compositions of the present technology may further comprise one or more adjuvants.
- An "adjuvant” is a substance that serves to enhance, accelerate, or prolong the antigen- specific immune response of an antigen when used in combination with specific vaccine antigens but do not stimulate an immune response when used alone.
- Suitable adjuvants include inorganic or organic adjuvants.
- Suitable inorganic adjuvants include, but are not limited to, for example, an aluminium salt such as aluminum hydroxide gel (alum) or aluminium phosphate (preferably aluminium hydroxide), but may also be a salt of calcium (particularly calcium carbonate), iron or zinc, or may be an insoluble suspension of acylated tyrosine, or acylated sugars, cationically or anionically derivised polysaccharides or polyphosphazenes.
- an aluminium salt such as aluminum hydroxide gel (alum) or aluminium phosphate (preferably aluminium hydroxide)
- a salt of calcium particularly calcium carbonate
- iron or zinc or may be an insoluble suspension of acylated tyrosine, or acylated sugars, cationically or anionically derivised polysaccharides or polyphosphazenes.
- suitable adjuvants are known to one skilled in the art.
- ThI adjuvant systems may also be used, and include, but are not limited to, for example, Monophosphphorly lipid A, other non-toxic derivatives of LPS, and combination of monophosphoryl lipid A, such as 3-de-O-acrylated monophosphorly lipid A (#D-MPL) together with an aluminium salt.
- Monophosphphorly lipid A other non-toxic derivatives of LPS
- monophosphoryl lipid A such as 3-de-O-acrylated monophosphorly lipid A (#D-MPL) together with an aluminium salt.
- adjuvants include, but are not limited to, MF59, MPLA, Mycobacterium tuberculosis, Bordetella pertussis, bacterial lipopolysaccharides, aminoalkyl glucosamine phosphate compounds (AGP), or derivatives or analogs thereof, which are available from Corixa (Hamilton, Mont.), and which are described in U.S. Pat. No.
- COG-ODN CpG oligodeoxynucleo tides
- polypeptides such as Quil A or STIMULONTM QS-21 (Antigenics, Framingham, Mass.), described in U.S. Pat. No. 5,057,540, a pertussis toxin (PT), or an E. coli heat-labile toxin (LT), particularly LT-K63, LT-R72, CT-S109, PT- K9/G129; see, e.g., International Patent Publication Nos. WO 93/13302 and WO 92/19265, cholera toxin (either in a wild-type or mutant form).
- various oil formulations such as stearyl tyrosine (ST, see U.S. Pat. No. 4,258,029), the dipeptide known as MDP, saponin, cholera toxin B subunit (CTB), a heat labile enterotoxin (LT) from E. coli (a genetically toxoided mutant LT has been developed), and Emulsomes (Pharmos, LTD., Rehovot, Israel).
- Various cytokines and lymphokines are suitable for use as adjuvants.
- One such adjuvant is granulocyte-macrophage colony stimulating factor (GM-CSF), which has a nucleotide sequence as described in U.S. Pat. No. 5,078,996.
- GM-CSF granulocyte-macrophage colony stimulating factor
- cytokine Inter leukin- 12 is another adjuvant which is described in U.S. Pat. No. 5,723,127.
- Other cytokines or lymphokines have been shown to have immune modulating activity, including, but not limited to, the interleukins 1- ⁇ , 1- ⁇ , 2, 4, 5, 6, 7, 8, 10, 13, 14, 15, 16, 17 and 18, the interferons- ⁇ , ⁇ and ⁇ , granulocyte colony stimulating factor, and the tumor necrosis factors ⁇ and ⁇ , and are suitable for use as adjuvants.
- the vaccine compositions can be lyophilized to produce a vaccine against N. meningitidis in a dried form for ease in transportation and storage.
- the vaccine may be prepared in the form of a mixed vaccine which contains the NOMVs containing the proteins from the genetically altered strains described above and at least one other antigen as long as the added antigen does not interfere with the effectiveness of the vaccine and the side effects and adverse reactions are not increased additively or synergistically.
- the vaccine can be associated with chemical moieties which may improve the vaccine's solubility, absorption, biological half life, etc. The moieties may alternatively decrease the toxicity of the vaccine, eliminate or attenuate any undesirable side effect of the vaccine, etc. Moieties capable of mediating such effects are disclosed in Remington's Pharmaceutical Sciences (1980). Procedures for coupling such moieties to a molecule are well known in the art.
- the vaccine may be stored in a sealed vial, ampule or the like.
- the present vaccine can generally be administered in the form of a spray for intranasal administration, or by nose drops, inhalants, swabs on tonsils, or a capsule, liquid, suspension or elixirs for oral administration.
- the vaccine is dissolved or suspended in sterilized distilled water before administration.
- Any inert carrier is preferably used, such as saline, phosphate buffered saline, or any such carrier in which the NOMV vaccine has suitable solubility.
- Vaccine compositions of the present technology may include a carrier. If in a solution or a liquid aerosol suspension, suitable carriers can include, but are not limited to, salt solution, sucrose solution, or other pharmaceutically acceptable buffer solutions. Aerosol solutions may further comprise a surfactant.
- acceptable vehicles and solvents include water. Ringer's solution, and isotonic sodium chloride solution, including saline solutions buffered with phosphate, lactate , Tris and the like.
- sterile, fixed oils are conventionally employed as a solvent or suspending medium, including, but not limited to, for example, synthetic mono- or di-glycerides.
- fatty acids such as oleic acid find use in the preparation of injectables.
- Injectable preparations for example sterile injectable aqueous or oleaginous suspensions, are formulated according to the known art using suitable dispersing or wetting agents and suspending agents.
- the sterile injectable preparation are also a sterile injectable solution or suspension in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol.
- Example 1 Derivation of the genetically modified vaccine strain of N. meningitidis and production of NOMVs containing the outer membrane proteins of the genetically modified vaccine strain.
- the genetically modified strain 8570 HOPS-Gl was modified by five genetic modifications from a parental strain 8570 which had been analyzed by multilocus enzyme electrophoresis by the laboratory from whom the strain was obtained and determined to belong to the ET-5 clonal complex (Caugant, et al.) The PorA variable regions were sequenced typed and the LOS immunotype was verified before the genetic modifications were made.
- Strain 8570 was and ET-5 clone 4:P1.19, 15:L7v, ProB3 (ST4) Tbp2 type II. A series of five sequential genetic modifications were made to the strain as described below:
- a second, different porA gene was inserted at the opaD locus knocking out the opaD gene.
- pUC 19 -based plasmid pA 18.4 has no antibiotic resistance marker in the insert, was used to insert a second porA gene into the chromosome at the opaD locus, disabling opaD by replacing a 100 bp sequence in the middle of the gene with the insert.
- the insert contained the new porA gene taken from strain M4410 (B:15:PI.22,14) and placed behind a porA promoter taken from strain H44/76.
- the resulting porA type was Pl.19, 15: Pl.22, 14 containing the two porin A genes.
- the replacement sequence was chosen to contain a restriction site for Notl to enable verification of the presence of the replacement sequence.
- the plasmid used for the transformation was p ⁇ pc79 (Seq. ID No. 4).
- the plasmid insert does not contain an antibiotic marker. Selection of transformants was based on colony blotting with monoclonal antibody to OpcA.
- the strain to be transformed was chosen to be an OpcA negative phase variant, and strong OpcA positive clones were identified by colony blotting. True transformants were distinguished from OpcA positive phase variants by PCR and restriction enzyme (Not I) analysis.
- the gene ipxLl which is an acyl transferase responsible for linking one of two acyl-oxy-acyl linked fatty acids to the lipid A of the LOS, was disabled by replacing a 260 bp sequence in the middle of the IpxLl gene with an insert containing the tetM antibiotic resistance gene.
- the tetM gene was obtained from a plasmid pJS1934, which was derived from the transposon Tn916 (Swartley, et al. 1993. MoI. Microbiol. 10:299-310).
- the plasmid used to disable the IpxLl gene was pMn5 (Seq. ID No. 5). The presence of the insert in the IpxLl gene was verified by PCR which produced a 3.3 kbp amplicon using primers at the beginning and end of the IpxLl gene.
- step 3 Expression of the conserved outer membrane protein GNA 1870 (variant 1) (FHBP v.l) was increased by inserting a second copy of the GNA 1870 variant 1 gene in the nspA locus, knocking out expression of NspA.
- the newly inserted gene was part of an insert that contained a gentamicin antibiotic resistance gene, the E. coli lac operon with the IPTG-inducible Ptac promoter, the GNAl 870 variant 1 gene and the rrnB terminator, the plasmid used is depicted in Figure 19c and Seq. ID No. 6.
- the PUC19 based plasmid, pBE/GNAl 870/101, was used in the transformation and homologous recombination to insert the GNA 1870 variant 1 gene into the modified strain.
- pBE/GNA1870/101 plasmid (7687 b.p.) was constructed with the features as described in in Table 1 (sequence can be found in Seq. ID No. 6).
- step 4 The strain resulting from step 4 was transformed with a pUC 19 -based plasmid containing the synX gene in which a 200 bp sequence was replaced by a kanamycin resistance gene. Kan resistant transformants were selected and tested by PCR for the presence of the disrupted synX gene and for the capsule negative phenotype. The results verified the knockout of the synX gene.
- step 4 The strain resulting from step 4 was transformed with a plasmid pBE-501 containing zeomycin gene knocking out the lgtA gene (Seq. ID No. 9). Plasmid pBE-501 contained the features found in Table 2. Knock-out of the lgtA gene produced expression of a shortened or truncated LOS that lacks the lacto-N-neotetraose (LNnT) tetrasaccharide (see Figure 20).
- LNnT lacto-N-neotetraose
- Example 2 Production of Vaccine amounts of the genetically modified strain
- the genetically modified strains were then used for production of master and production cell banks for use in vaccine manufacture as detailed in the flow-charts in Figures 1-5 to produce a composition of NOMVs.
- the NOMVs culture is tested for the expression of the outer membrane proteins and LOS.
- Example 2 The final product obtained from Example 2 was subjected to quality control testing and preclinical safety and immunogenicity testing in mice and rabbits.
- composition of the final product vaccine was:
- the vaccine composition was further analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis and western blotting.
- Figure 6 depicts coomassie blue stained gel showing protein content in the vaccine (lane 4) as compared to control (lane T) and filtered bulk lot (lane 3).
- Figure 7 depicts silver stain gel showing the liposaccharide component of the vaccine (lane 3) as compared with control (ML5 LPS, land 1) and filtered bulk vaccine lot (lane T).
- Figure 8 depicts the results of identity testing of the vaccine for the major components of the NOMVs vaccine according to the antibodies as listed in Table 3. Table 3
- the vaccine was tested for endotoxin content by measuring its ability to induce proinflammatory cytokines TNF-alpha and IL-6, from fresh whole human blood. The results are shown in Figures 9 and 10.
- the data are the mean of 3 (E. CoIi LPS Standard and NOMV vaccine lot 1119 with lpxL2 LOS) or 5 (Lot 0832 NOMV with wild type LOS, and Lot 1289 NOMV vaccine with ipxLl LOS) tests.
- the error bars are the standard error of the mean.
- the concentration of NOMV is based on protein but the E. CoIi standard LPS is based on LPS by weight.
- mice were given three doses of genetically modified vaccine strain 8570 HOPS-G at four week intervals with or without adsorption to aluminum hydroxide adjuvant (Rehydragel LV). Groups of 10 mice were vaccinated intraperitoneally at 0, 4 and 8 weeks with 0.1, 0.3, 1.0 or 3.0 ⁇ g of NOMV, the vaccine groups are listed in Table 6. Serum was taken at 0, 7 and 10 weeks. The sera were tested for bactericidal antibodies against four different strains, the parent of the vaccine strain and several related strains using normal human serum as a source of complement. Pre- vaccination sera were uniformly lacking in bactericidal activity.
- FIG. 12 The results obtained with the 10-week sera (three doses of vaccine) are shown in Figure 12 showing the bactericidal titer of the different vaccine groups for the genetically modified stains.
- Two of the test strains were isogenic with the parent of the vaccine strain. They were derived from the parent strain by replacing the porA gene with an alternate porA having a different serosubtype specificity. Two of the PorA proteins expressed in these test strains are present in the vaccine (Pl .19, 15 and Pl.22,14), but the third (Pl .22-1,4) is not.
- the fourth strain, 44/76 has a different PorA, a different PorB, and a different LOS core structure as compared to the vaccine strain.
- the conserved protein GNAl 870 appeared to remove about 20% of the bactericidal activity, which, not to be bound by any particular theory, may indicate some cooperative killing involving both anti-LOS antibody and anti-GNA1870 antibody as shown in Figure 14.
- the vaccine was also tested for immunogenicity in rabbits.
- Groups of four rabbits were vaccinated intramuscularly with different doses of vaccine, with or without adsorption to aluminum hydroxide adjuvant. Three doses were given at six week intervals and blood was drawn two weeks after the last injection.
- the bactericidal antibody response of the rabbits to four test strains was determined.
- the test strains included 3 isogenic variants of 8570 expressing different PorA proteins and L3,7v LOS and strain 44/76 which has a heterologous PorA and LOS with a different core structure.
- PorA proteins Pl.19, 15 and Pl.22,14 were present in the vaccine, but Pl.22-1,4 was not.
- the results of the bactericidal tests are given in Figure 15.
- Example 9 Preparation and Animal Testing of a Laboratory Lot of the Complete Multivalent NOMV Vaccine.
- strain B 16B6 (B:2a:P 1 .5,2:L2). This strain belongs to the genetic group ET-37 and has a class 2 PorB protein and type I transferrin binding protein B.
- strain 44/76 (B:15:P1.7,16:L3,7), which belongs to the genetic group ET-5 and is representative of the epidemic strain responsible for the group B meningococcal epidemic in Norway in the 1970's and 1980's. It expresses a class 3 PorB protein and type II transferrin binding protein B.
- Strain B16B6 was genetically modified in much the same manner as described for strain 8570 HOPS-Gl. Two genes were disabled, synX and ipxLl, to prevent capsule synthesis and sialylation of LOS and to reduce the toxicty of the LOS. A second porA gene (subtype Pl.22-4) was inserted in place of the opaD gene. Variant 2 of GNA 1870 (FHBP) with the IPTG inducible E. coli Ptac promoter, was inserted in place of the nspA gene as a second copy using plasmid pBE-201 (Seq. ID. No 7). Plasmid pBE-201 (7687 b.p. for additional expression of fHBP (variant 2)) was constructed with the features as described in Table 7 .
- FHBP GNA 1870
- Plasmid pBE-201 7687 b.p. for additional expression of fHBP (variant 2)
- HOPS-Gl The two genes, synX and ipxLl, were disabled by insertion mutagenesis, a second porA gene (subtype Pl.7-1, 1) was inserted along with its promoter in place of the opaD gene, and a second copy of nadA was inserted behind a porA promoter in place of the nspA gene.
- Plasmid pBE-311 was used for homologous recombination to insert the NadA gene, the plasmid 3-11 was constructed with the features as described in Table 8 and the sequence can be found in Seq. ID No. 8.
- Example 10 Preparation of NOMV Vaccine from Strains B16B6 HPS-G2 and 44/76 HOPS-D.
- the three genetically modified strains were used to prepare laboratory lots of NOMV vaccine compositions.
- the strains were grown in Catlin's modified medium as one liter cultures in Fernbach flasks on a rotary shaker.
- the cells were harvested by centrifugation, weighed and the cell paste frozen.
- the cell paste was thawed and used to prepare NOMV following essentially the same procedure as described for the clinical lot of vaccine from strain 8570 HOPS-Gl as described in
- Example 2 The process was scaled down and ultracentrifugation twice at 225,000 x g for 60 min at 2- 8 °C to remove nucleic acids and all soluble, no n- vesicle material.
- mice Groups of ten CD-I mice were vaccinated intraperitoneally with two pg of NOMV vaccine from each genetically modified vaccine strain (6 pg total for the combined vaccine with NOMV from three strains). Three doses were given at 0, 4, and 8 weeks. Blood was drawn pre-vaccination and 2 weeks following the last vaccination (at 10 weeks).
- the combined multivalent vaccine induced a geometric mean 1 :256 titer against each of the three vaccine strains and a 4-fold or greater increase in bactericidal antibodies against 13 of the 15 heterologous strains. Two of the test strains were not killed in spite of having an antigen shared with one of the vaccine strains.
- the bactericidal titers observed against the panel of strains are given in the Table 9.
- mice were vaccinated with NOMV vaccine prepared from isogenic mutants of strain 8570 HOPS-Gl.
- the mutant strains differed in their expression of PorA.
- Two mutants expressed a single PorA (one or the other of the two in the multivalent vaccine strain) and the third was a PorA knockout mutant expressing no PorA protein.
- Bactericidal titers induced by each of the four strains against several different test strains are shown in Table 10.
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WO2012025873A3 (en) * | 2010-08-23 | 2012-05-18 | Wyeth Llc | STABLE FORMULATIONS OF NEISSERIA MENINGITIDIS rLP2086 ANTIGENS |
CN102869377A (zh) * | 2010-03-10 | 2013-01-09 | 葛兰素史密丝克莱恩生物有限公司 | 免疫原性组合物 |
JP2013537884A (ja) * | 2010-09-10 | 2013-10-07 | グラクソスミスクライン バイオロジカルズ ソシエテ アノニム | 髄膜炎菌に対するワクチン |
WO2013132040A3 (en) * | 2012-03-08 | 2013-11-21 | Novartis Ag | In vitro potency assay for protein-based meningococcal vaccines |
US9107873B2 (en) | 2001-10-11 | 2015-08-18 | Wyeth Holdings Llc | Immunogenic compositions for the prevention and treatment of meningococcal disease |
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Also Published As
Publication number | Publication date |
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JP2015061870A (ja) | 2015-04-02 |
AU2009262893B2 (en) | 2015-05-21 |
ZA201008548B (en) | 2012-06-27 |
RU2010153658A (ru) | 2012-08-10 |
CN102105166A (zh) | 2011-06-22 |
AU2009262893A1 (en) | 2009-12-30 |
UA99659C2 (uk) | 2012-09-10 |
KR20110053314A (ko) | 2011-05-20 |
ECSP10010723A (es) | 2011-05-31 |
DOP2010000364A (es) | 2011-07-15 |
US9387239B2 (en) | 2016-07-12 |
MX2010012999A (es) | 2012-03-07 |
CO6341569A2 (es) | 2011-11-21 |
US20170100471A1 (en) | 2017-04-13 |
NZ589812A (en) | 2012-08-31 |
US20110182942A1 (en) | 2011-07-28 |
BRPI0913268A2 (pt) | 2016-03-15 |
RU2477145C2 (ru) | 2013-03-10 |
CR11812A (es) | 2011-07-06 |
AU2009262893A9 (en) | 2015-05-21 |
EP2296699A4 (en) | 2013-11-13 |
CA2726465A1 (en) | 2009-12-30 |
JP2011521976A (ja) | 2011-07-28 |
EP2296699A1 (en) | 2011-03-23 |
IL209660A0 (en) | 2011-02-28 |
JP5723768B2 (ja) | 2015-05-27 |
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